Temporal Trends in Patient Characteristics and Outcomes Among Medicare Beneficiaries Undergoing Primary Prevention Implantable Cardioverter-Defibrillator Placement in the United States, 2006–2010
Why the study?
Do clinical outcomes improve over time (2006 vs 2010) in older Medicare beneficiaries undergoing primary prevention ICD placement?
Population
117,100 Medicare fee-for-service beneficiaries aged ≥65 years with left ventricular ejection fraction ≤35%…
Comparison
Primary prevention implantable… vs Temporal comparison.
Design
Cohort
Follow-up
180 days
Authors
Discussion
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Member takes
Implication
Improved post-ICD outcomes over time in older Medicare patients support quality monitoring; leaves open causal drivers and requires prospective confirmation.
Structured PICO
Do clinical outcomes improve over time (2006 vs 2010) in older Medicare beneficiaries undergoing primary prevention ICD placement?
P
Population
117,100 Medicare fee-for-service beneficiaries aged ≥65 years with left ventricular ejection fraction ≤35% who underwent primary prevention ICD implantation (including concomitant cardiac resynchronization therapy) in US hospitals between 2006 and 2010.
I
Intervention
Primary prevention implantable cardioverter-defibrillator (ICD) placement, including cardiac resynchronization therapy (CRT), between 2006 and 2010.
C
Comparator
Temporal comparison (implantation in 2006 vs. 2010).
O
Outcome
Mortality and hospitalization (all-cause and heart failure) at 180 days, and device-related complications.hard clinical
Between 2006 and 2010, clinical outcomes including mortality, rehospitalization, and device-related complications significantly improved among older Medicare beneficiaries undergoing primary prevention ICD implantation.
Cite This Study
Borne et al. (2014) studied this question.